chapter 8 lecture drinking alcohol responsibly and ending tobacco use © 2015 pearson education, inc

Chapter 8 Lecture

© 2015 Pearson Education, Inc.

Drinking Alcohol Responsibly andEnding Tobacco Use


LEARNING OUTCOMES

• Explain the health risks and effects of alcohol consumption.

• Discuss the alcohol use patterns of college students and overall trends in consumption.

• Explain the physiological and behavioral effects of alcohol, including blood alcohol concentration, absorption, and metabolism.

• Identify the long-term effects of alcohol consumption.• Describe the symptoms and causes of alcoholism, its

cost to society, and effects on the family.• Explore treatment options for alcohol dependence.


LEARNING OUTCOMES (cont.)

• Discuss the social and political issues involved in tobacco use.

• Explain the scope of tobacco use in the United States.

• Describe the health risks and physical impact associated with using tobacco products.

• Explain the dangers of environmental tobacco smoke.

• Assess the effectiveness of tobacco use and prevention policies.

• Describe methods and benefits of smoking cessation.


Alcohol: An Overview

• Very low levels of alcohol, particularly red wine, may lower some health risks in older adults.

• Half of all Americans consume alcoholic beverages regularly; about 21 percent abstain.

• Men typically drink more regularly and drink more than women.


Alcohol and College Students

• Approximately 62 percent of students report having consumed an alcoholic beverage in the past 30 days.

• Of college students, 39 percent engage in binge drinking. Binge drinking for men is consuming 5 or more drinks in about 2 hours; for women, consuming 4 or more.

• Alcohol use among college students disrupts sleep, decreases alertness, and may affect academic performance.


College Students' Patterns of Alcohol Use in the Past 30 Days


High-Risk Drinking and College Students

• Alcohol exacerbates risk for suicide, automobile crashes, and falls.

• Many college and university students' customs and celebrations encourage certain dangerous practices and patterns of alcohol use.

• Advertising and promotions from the alcoholic beverage industry heavily target university campuses.

• Beer and other drink specials enable students to consume large amounts of alcohol cheaply.

• College students are more likely to drink recklessly.• College students are vulnerable to peer influence.• Administrators often deny that a problem exists.


ABC News Video: Sloppy SpringBreaker

Discussion Questions• Who should be held responsible in a potentially

dangerous situation that involves a visually intoxicated woman and a male who attempts to take advantage of her? (i.e., the bartender, her friends, herself)?

• Would you feel responsible for helping a visually intoxicated woman who is seemingly being taken advantage of by a male patron at the bar? How would you react in a similar situation to the ones in the video?

• Discuss ground rules or ways to keep friends safe while on spring break if one of your friends gets intoxicated.

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Prevalence of Negative Consequences of Drinking among College Students, Past Year


Efforts to Reduce Student Drinking

• Brief Alcohol Screening and Intervention for College Students (BASICS) has been effective for heavy-drinking students with already existing or risk for problems related to alcohol.

• E-intervention, electronically based alcohol education interventions using text messages,e-mails, and podcasts, and Alcohol e-Check Up to Go (e-Chug) have shown promise in reducing alcohol problems in first-year students.

• A social norms approach to reduce alcohol consumption is also used.


Alcohol in the BodyThe Chemistry and Potency of Alcohol • Ethyl Alcohol or Ethanol

– The intoxicating substance in all alcoholic beverages

• Fermentation Process – Yeast organisms break down sugar.

• Distillation – Alcohol vapors are released from the mash at

high temperatures.• Proof

– Measure of the percent alcohol• 80 proof whiskey = 40 percent alcohol


What Is a Standard Drink?


Absorption and Metabolism

• About 20 percent of absorption occurs in the stomach.

• About 80 percent of absorption occurs in the small intestine.

• Factors that influence absorption– Concentration of the drink – Amount consumed– Food in the stomach– Mood– Pylorospasm (spasm of valve)


Absorption and Metabolism (cont.)

• Alcohol contains 7 calories per gram.• The breakdown of alcohol is fairly constant at

about 0.5 ounce per hour (about one standard drink.)

• Unmetabolized alcohol circulates in the bloodstream until enough time passes for the body to break it down.


Blood Alcohol Concentration (BAC)

• Ratio of alcohol to total blood volume• The legal limit for BAC is 0.08 percent in all

states.• Both breath analysis (breathalyzer tests) and

urinalysis are used to determine whether an individual is legally intoxicated, but blood tests are more accurate.

• Learned behavioral tolerance—even though BAC may be quite high, the individual has learned to modify his behavior to appear sober.


The Psychological and Physical Effects of Alcohol


Blood Alcohol Concentration (BAC) (cont.)

• A drinker's BAC depends on – Weight and body fat – The water content in the body tissues– The concentration of alcohol in the beverage

consumed.– Alcohol concentration is higher in people with

more body fat; women generally have more body fat than men.

– Women have half as much alcohol dehydrogenase as men.


Approximate Blood Alcohol Concentration (BAC) and the Physiological and Behavioral Effects


Effects of Alcohol on the Body and Health


Alcohol and Your Health Immediate and Short-Term Effects of Alcohol• Alcohol depresses central nervous system

(CNS) functions.• Vital functions become noticeably affected, and

in extreme cases, coma and death can result.• Alcohol is a diuretic, but water is pulled out of

the cerebrospinal fluid, resulting in "morning-after" headaches.


Immediate and Short-Term Effects of Alcohol (cont.)• Alcohol irritates the gastrointestinal system.• Brief drinking sprees of high amounts increase

risk for irregular heartbeat or total loss of heart rhythm.

• Hangovers kick in for more than half of drinkers when BAC reaches 0.11. But, 20–25 percent of those who drink enough to reach that level do not experience them.


Immediate and Short-Term Effects of Alcohol (cont.)• Alcohol is involved in approximately 70 percent

of fatal injuries during activities such as boating and swimming.

• Heavy drinking is associated with dating violence

• One drink can add 100 calories to your daily intake; adding 150 calories per day more than you need can result in weight gain of 12 pounds a year.


Alcohol Poisoning

• Acute alcohol intoxication can be fatal.• The amount of alcohol that causes

unconsciousness is dangerously close to a fatal dose.

• BAC continues to rise even after a drinker is unconscious.

• Signs include inability to be roused; weak, rapid pulse; cool, pale, or bluish skin.

• Call 9-1-1 immediately.


Long-Term Effects of Alcohol

• Effects on the nervous system• Cardiovascular effects• Liver disease• Cancer• Other effects

– Chronic inflammation of the pancreas– Blocked absorption of calcium– Reduced ability of the body to fight bacteria

and viruses.


Comparison of a Healthy Liver with a Cirrhotic Liver


Alcohol and Pregnancy

• Teratogenic substances cause birth defects; alcohol is one of the most dangerous and common.

• 7.6 percent of children have been exposed to alcohol in utero; 1.4 percent of pregnant women report binge drinking.

• Fetal alcohol syndrome (FAS)– Mental retardation, impaired learning, poor memory,

small head, tremors, impulsive behaviors, reduced attention span, and abnormalities of face, limbs, heart, and brain.

– FAS is the third most common birth defect in the United States.


Alcohol and Pregnancy


Drinking and Driving

• Thirty-one percent of all traffic fatalities in 2010 were alcohol related.

• Among college students, 15.1 percent drink and drive.

• In 2010, there were 10,228 alcohol-impaired driving fatalities in the United States.– This represents one alcohol-related fatality

every 51 minutes.• The likelihood of a driver being involved in a

fatal crash rises significantly with a BAC of 0.05 percent and even more rapidly after 0.08 percent.


Percentage of Fatally Injured Drivers with BACs Greater Than 0.08 percent, by Driver Age, 1982–2011


Abuse and Dependence

• Alcohol use becomes alcohol abuse when it interferes with work, school, or social and family relationships, or when it entails law violations, including DUI.

• Alcoholism or alcohol dependence occurs when alcohol use is so severe that stopping alcohol results in withdrawal symptoms.

• Identifying an Alcoholic– Craving, loss of control, tolerance, psychological

dependence, and withdrawal symptoms must be present to qualify a drinker as an addict.

– About 15 percent of people in the United States are problem drinkers.

– One study shows that 25 percent of college students meet the criteria for alcohol abuse or dependence in the past year.


The Causes of Alcohol Abuse and Alcoholism• Biological and Family Factors

– Higher rates of alcoholism occur among children of alcoholics.

– Scientists have not identified an alcoholism gene.

• Social and Cultural Factors– Family attitudes

• People raised in cultures in which alcohol is part of religious or ceremonial activities are less prone to dependence than people raised where purchase is controlled and alcohol use is regarded as a rite of passage.


Women and Alcoholism

• Women become alcoholic at later ages and after fewer years of heavy drinking than do male drinkers.

• Women get addicted faster.• Women have greater risks for cirrhosis;

excessive memory loss and shrinkage of the brain; heart disease; and cancers of the mouth, throat, esophagus, liver, and colon.

• Risk factors include being unmarried but living with a partner; being in 20s or 30s, with a husband or partner who drinks heavily; family history; pressure to drink; depression and stress.


Alcohol and Prescription Drug Abuse

• Alcohol and prescription drugs taken together can cause– Alcohol poisoning– Unconsciousness– Respiratory depression– Death

• Opioids, stimulants, sedatives, and sleeping aids are most often combined with alcohol.


Costs to Society

• Alcohol-related societal costs are estimated to be over $223.5 billion when health insurance, criminal justice costs, treatment costs, and lost productivity are factored in.

• Alcoholism is directly or indirectly responsible for over 25 percent of the nation's medical expenses and lost earnings.

• Underage drinking costs $61.9 billion annually.– Costs include violence, drunk driving, high-

risk sex, property crime, and addiction treatment.


Treating Alcoholism

• Alcoholics who decide to quit will experience detoxification and may experience the following withdrawal symptoms:– Hyperexcitability– Confusion– Agitation– Sleep disorders– Convulsions– Hand tremors– Depression– Headache– Seizure– Possible delirium tremors (DTs)

• Treatment programs include– Private facilities– Therapy


Relapse

• Success rates vary, but over half of alcoholics relapse within the first 3 months of treatment.– Treatment requires more than drinking

cessation.• There must be a guard against relapse.• Identifying situations that could result in relapse,

such as becoming angry, frustrated, being around drinkers, being pressured to drink, must be identified.

• Joining a support group helps.• Effective recovery programs help addicts create

self-esteem and resume personal growth.


Tobacco Use in the United States

• Nearly 443,000 Americans die annually of tobacco-related diseases.

• Another 10 million suffer tobacco-induced health disorders.

• Tobacco causes about 20 diseases, and about half of all regular smokers die of smoking-related diseases.


Tobacco and Social Issues

• Advertising– $36 million is spent daily on advertising and

promotion.– Ninety percent of adults who smoke started

by age 21, and half became regular smokers by age 18.

• Financial Costs to Society– Tobacco use causes more than $193 billion in

annual health-related economic issues.– For each smoker, the cost is about $3,100

per year.


Percentage of Population That Smokes (Age 18 and Older) among Select Groups in the United States


College Students and Tobacco Use

• Heavy tobacco marketing and advertising is aimed at students, but smoking among college students is declining.– Why do college students smoke?

• To relax or reduce stress• To fit in/social pressure• Because of addiction

– Social smoking• Many students identify themselves as social

smokers: those that smoke only around other smokers.

• This can lead to dependence and all the same health risks as smoking regularly.


Tobacco and Its Effects

• Nicotine– Highly addictive, psychoactive substance– CNS stimulant

• Tar and Carbon Monoxide– Tar is the carcinogenic particulate matter.– Nicotine paralyzes cilia, which become

unable to clear out tar.– Carbon monoxide is a deadly gas that

reduces the oxygen-carrying capacity of red blood cells.

• Tobacco Addiction– Nicotine poisoning


Trends in Prevalence of Cigarette Smoking in the Past Month among College Students


Tobacco Products

• Cigarettes– Filtered cigarettes may deliver more hazardous

gases.– Switching to low-tar or low-nicotine is self-defeating

because the smoker may smoke more.– Clove cigarettes contain 60 percent tobacco.

• Cigars– Contain 23 poisons and 43 carcinogens.

• Bidis– Produce three times more carbon monoxide and

nicotine and five times more tar than do cigarettes.


Tobacco Products (cont.)

• Pipes and Hookahs– Water pipes may cut down on throat irritation.– The main ingredient in hookahs is tobacco.– A hookah does not filter out harmful chemicals found

in tobacco smoke.• Smokeless tobacco

– Chewing tobacco• Dipping rapidly releases nicotine into the

bloodstream.– Snuff

• Can be inhaled, chewed, or placed against the gums.

• Smokeless tobacco is just as addicting as cigarette smoking.


Health Hazards of Tobacco Products— Cancer• Lung cancer is the leading cause of cancer death.

– Of lung cancers, 85–90 percent are caused by smoking tobacco.

• It can take 10–30 years to develop, and most cases are not diagnosed until the cancer has spread. – Five-year survival rate is only 16 percent.

• Smoking just one cigar a day can double the risk of several cancers.• Chewing tobacco is responsible for the majority of new oral cancers,

which can begin as leukoplakia.– Warning signs include lumps in the jaw or neck, color changes

or lumps inside the lips, white smooth or scaly patches in the mouth or neck, lips or tongue; a red spot or sore on the lips, gums, or inside the mouth that does not heal in 2 weeks.

• Other tobacco-induced cancers include pancreatic, kidney, bladder, lip, tongue, esophagus, and larynx


Effects of Smoking on the Body and Health


Health Hazards of Tobacco Products—Cardiovascular Disease• Smokers have a 70 percent higher death rate

from heart disease than do nonsmokers.• Daily cigar smoking doubles the risk of heart

attack and stroke. • Smoking contributes to heart diseases by adding

the equivalent of 10 years of aging to the arteries.

• Smokers are twice as likely to suffer strokes.


Lung Damage from Chemicals in Tobacco Smoke


Health Hazards of Tobacco Products (cont.)

• Respiratory Disorders– Chronic bronchitis– Emphysema

• Sexual Dysfunction and Fertility Problems– Males are more likely to suffer impotence

than are nonsmokers.– Women are likely to suffer infertility, problems

with pregnancy, and problems for the child after birth.

• Unique Risks for Women• Smokers are 26 times more likely to die from lung

cancer than are nonsmokers.



• Unique Risks for Women (cont.)– Higher rates of osteoporosis, depression, and

thyroid-related diseases.– Increased risk for blood clots, especially in

smoking women who take birth control pills.– Heavier menstrual bleeding, longer duration

of cramps, less predictable length of menstrual cycle.



• Other Health Effects– Gum disease, macular degeneration,

premature skin wrinkling, staining of the teeth, yellowing of fingernails, and bad breath.

– Nicotine speeds up the process by which the body uses and eliminates drugs, making medication less effective.

– Smoking significantly increases the risk for Alzheimer's disease.


Environmental Tobacco Smoke (ETS)

• Mainstream—smoke drawn through tobacco while inhaling.

• Sidestream—smoke from the burning end of a cigarette or smoke exhaled by a smoker – Contains twice as much tar and nicotine, 5 times

more carbon monoxide, and 50 times more ammonia than mainstream smoke.

– Causes more deaths a year than any other environmental pollutant.

• Every year, ETS is estimated to be responsible for 3,400 lung cancer deaths, 46,000 coronary and heart disease deaths, and higher risk of SIDs deaths in newborns.


Tobacco Use and Prevention Policies

• It has been over 40 years since the government recognized the hazards of tobacco use.

• In 1998, the tobacco industry reached a Master's Settlement Agreement with 40 states.

• The Family Smoking Prevention and Tobacco Control Act (2009) forbids advertising geared to children, forbids nicotine reduction, and bans sweetened cigarettes.

• Smokeless tobacco ads must have a warning that fills 20 percent of the advertising space.

• Cigarette packages were required to have bigger, stronger warnings, but lawsuits by tobacco companies prevented their implementation in 2012.


Quitting Smoking

• Breaking the Nicotine Addiction– Seventy percent attempt to quit each year.– Only between 4 and 7 percent succeed.– Options include going "cold turkey," gradual

reduction, short-term programs based on behavior modification and a system of rewards, and treatment centers.

– Combining several approaches has the most promise.


Coping Strategies for Common Smoking Withdrawal Problems


Quitting (cont.)

• Breaking the Nicotine Addiction• Symptoms of withdrawal include irritability,

restlessness, nausea, vomiting, and intense craving for tobacco.

• Nicotine Replacement Products– Nicotine chewing gum– Nicotine patches– Nasal spray– Nicotine inhaler– Smoking cessation medications


ABC News Video: Do NicotinePatches and Gum Work?

Discussion Questions• What impacts have state and national laws had

on rates of smoking?• How involved should the state be in regulating

smoking and/or making it difficult for people to smoke?

• New York is discussing increasing the age for people to purchase cigarettes to 21. Discuss reasons to support the increase in age, and discuss reasons why the state should not increase the age to 21.

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When Smokers Quit


Quitting Smoking (cont.)

• Benefits of Quitting– Many tissues will repair themselves,

according to the American Cancer Society.– Circulation and the senses of taste and smell

improve within weeks.– Risk of heart attack falls by half after only 1

year without smoking.– Can save about $2,184 per year.

chapter 8 lecture drinking alcohol responsibly and ending tobacco use © 2015 pearson education, inc

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